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KMID : 1100920240450010027
Korean Journal of Family Medicine
2024 Volume.45 No. 1 p.27 ~ p.36
Decision-Making on Contraceptive Use among Women Living with Human Immunodeficiency Virus in Malaysia: A Qualitative Inquiry
Surianti Sukeri

Zaharah Sulaiman
Noor Aman Hamid
Siti Aishah Ibrahim
Abstract
Background: Malaysia is the first country in the Western Pacific Region to receive the validation certificate for the elimination of mother-to-child transmission of human immunodeficiency virus (HIV). The validation report rec-ommends making sexual and reproductive health and rights of women living with HIV a priority. This article ex-plores and assesses the sexual and reproductive health, rights, and access to healthcare services of Malaysia¡¯s wom-en living with HIV (WLHIV).

Methods: A qualitative secondary analysis conducted on 73 WLHIV from all over Malaysia comprised 11 in-depth interviews and 16 focus group discussions. Data were extracted from the original interview transcripts that emerged from the following questions: (1) ¡°What are your experiences as a woman living with HIV in relation to your sexual and reproductive health and rights?¡± (2) ¡°What are your experiences in accessing contraception?¡± (3) ¡°What are your day-to-day experiences as a woman living with HIV?¡± Data were analyzed using thematic analysis.

Results: Four themes emerged from the study findings: ¡°lack of negotiation,¡± ¡°idealism in pregnancy,¡± ¡°coping with restrictions,¡± and ¡°past and future fears.¡± The four themes are grounded in religion, a patriarchal culture, meaning and expectations of motherhood, taking risks and going against medical advice to pursue fertility desires, fear of HIV transmission, and the side effects of contraceptive use.

Conclusion: The complexities involved in decision-making regarding contraceptive use revealed how WLHIV may have unresolved reproductive health needs inconsistent with healthcare providers¡¯ focus on HIV management and prevention. Suggestions are made for improving the sexual and reproductive health and rights of WLHIV in Malay-sia, which include establishing a reproductive health counseling program.
KEYWORD
Decision-Making, Family Planning, HIV, Acquired Immunodeficiency Syndrome, Qualitative Research, Reproductive Health, Sexual Health
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